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Drug resistance

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ultimately doomed to failure. Without alternative strategies, the acquisition of drug resistance by pathogenic microorganisms looms as possibly one of the most significant public health threats facing humanity in the 21st century. Some of the best alternative sources to reduce the chance of antibiotic resistance are probiotics, prebiotics, dietary fibers, enzymes, organic acids, phytogenics.
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evolutionary fitness as compared to susceptible pathogens. This is one of the reasons drug resistance adaptations are rarely seen in environments where antibiotics are absent. However, in the presence of antibiotics, the survival advantage conferred off-sets the high metabolic cost and allows resistant strains to proliferate.
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In short, the lack of concerted effort by governments and the pharmaceutical industry, together with the innate capacity of microbes to develop resistance at a rate that outpaces development of new drugs, suggests that existing strategies for developing viable, long-term anti-microbial therapies are
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Drug resistance has a high metabolic price in pathogens for which this concept is relevant (bacteria, endoparasites, and tumor cells.) In viruses, an equivalent "cost" is genomic complexity. The high metabolic cost means that, in the absence of antibiotics, a resistant pathogen will have decreased
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which is a key transporter of medications on the cellular level. If MDR1 is overexpressed, drug resistance increases. Therefore, ABCB1 levels can be monitored. In patients with high levels of ABCB1 expression, the use of secondary treatments, like metformin, have been used in conjunction with the
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by sending molecules of those antibiotics out of the bacterial cell. Sometimes a combination of different classes of antibiotics may be used synergistically; that is, they work together to effectively fight bacteria that may be resistant to one of the antibiotics alone.
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specific, any mutation in these molecules will interfere with or negate its destructive effect, resulting in antibiotic resistance. Furthermore, there is mounting concern over the abuse of antibiotics in the farming of livestock, which in the
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may be capable of surviving drug treatment. Drug-resistant traits are accordingly inherited by subsequent offspring, resulting in a population that is more drug-resistant. Unless the drug used makes sexual reproduction or
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Bacteria are capable of not only altering the enzyme targeted by antibiotics, but also by the use of enzymes to modify the antibiotic itself and thus neutralize it. Examples of target-altering pathogens are
253:, and dips. The chemicals contained in these preparations, besides harming beneficial organisms, may intentionally or inadvertently target organisms that have the potential to develop resistance. 1428:
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Reading: The Resistance Phenomenon in Microbes and Infectious Disease Vectors: Implications for Human Health and Strategies for Containment -- Workshop Summary - The National Academies Press
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Ghasabi M, Mansoori B, Mohammadi A, Duijf PH, Shomali N, Shirafkan N, Mokhtarzadeh A, Baradaran B (2019). "MicroRNAs in cancer drug resistance: Basic evidence and clinical applications".
511:, which represents a widespread problem nowadays, drugs designed to block the mechanisms of bacterial antibiotic resistance are used. For example, bacterial resistance against 1471: 637:
Alfarouk, KO; Stock, CM; Taylor, S; Walsh, M; Muddathir, AK; Verduzco, D; Bashir, AH; Mohammed, OY; Elhassan, GO; Harguindey, S; Reshkin, SJ; Ibrahim, ME; Rauch, C (2015).
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The development of antibiotic resistance in particular stems from the drugs targeting only specific bacterial molecules (almost always proteins). Because the drug is
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Ramos-Peñafiel C, Olarte-Carrillo I, Cerón-Maldonado R, Rozen-Fuller E, Kassack-Ipiña JJ, Meléndez-Mier G, Collazo-Jaloma J, Martínez-Tovar A (September 2018).
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and is a response to pressures imposed on any living organism. Individual organisms vary in their sensitivity to the drug used and some with greater
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Institute of Medicine (US) Forum on Emerging Infections; Knobler, S. L.; Lemon, S. M.; Najafi, M.; Burroughs, T. (2003). "Summary and Assessment".
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so that the antibiotics can work without getting destroyed by the bacteria first. Researchers have recognized the need for new drugs that inhibit
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In the domestic environment, drug-resistant strains of organism may arise from seemingly safe activities such as the use of
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Plasmid encode enzymes that chemically alter the drug (e.g., by acetylation or phosphorylation), thereby inactivating it.
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have also been shown to affect acquired drug resistance in cancer cells and this can be used for therapeutic purposes.
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Duckenfield, Joan (2011-12-30). "Antibiotic Resistance Due to Modern Agricultural Practices: An Ethical Perspective".
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This article is about pathogen resistance to the effects of drugs. For human resistance to the effects of drugs, see
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alone accounts for three times the volume dispensed to humans – leading to development of super-resistant bacteria.
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in bacteria inhibited by sulfonamides. Instead, like mammalian cells, they turn to utilizing preformed folic acid.
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challenge clinical care and drive research. When an organism is resistant to more than one drug, it is said to be
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impossible in the entire target population, resistance to the drug will inevitably follow. This can be seen in
1712:"Compensation of the Metabolic Costs of Antibiotic Resistance by Physiological Adaptation in Escherichia coli" 2890: 2515: 2443: 206:, and is termed horizontal gene transfer in which there is a direct exchange of genes, particularly in the 3020: 2633: 810: 2368: 2187: 2167: 280: 536: 2880: 2628: 2622: 69: 2149: 3010: 2945: 2647: 2157: : A web server for predicting inhibitors against drug tolerant M. Tuberculosis, published in 590: 146: 73: 65: 2696: 2458: 2453: 2363: 2281: 116: 459:
Bacteria change shape of the outer membrane porin proteins, preventing drug from entering cell.
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Gillespie SH, McHugh TD (September 1997). "The biological cost of antimicrobial resistance".
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The four main mechanisms by which microorganisms exhibit resistance to antimicrobials are:
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Händel, Nadine; Schuurmans, J. Merijn; Brul, Stanley; ter Kuile, Benno H. (August 2013).
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Wichelhaus TA, Böddinghaus B, Besier S, Schäfer V, Brade V, Ludwig A (November 2002).
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Bacteria make an altered penicillin-binding proteins, that do not bind to the drug.
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Fisher, Jed F.; Mobashery, Shahriar (2010). "Enzymology of Bacterial Resistance".
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Plasmid encode beta-lactamase, which open the beta-lactam ring, inactivating it.
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B. This protein stimulates the growth of cancer cells which are drug-resistant.
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Tegos GP, Haynes M, Strouse JJ, Khan MM, Bologa CG, Oprea TI, Sklar LA (2011).
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Binds to 30S Ribosome subunit, inhibiting protein synthesis by blocking tRNA
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Bacteria make an altered DNA topoisomerase that does not binds to the drug.
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Plasmid encode an enzyme that acetylate the drug, thereby inactivating it.
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Comprehensive Natural Products II. Volume 8: Enzymes and Enzyme Mechanisms
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Inhibit the enzyme dihydrofolate reduces, blocking the folic acid pathway
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Binds to penicillin-binding proteins, Inhibiting peptidoglycan synthesis
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Binds to penicillin-binding proteins, Inhibiting peptidoglycan synthesis
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Binds to penicillin-binding proteins, Inhibiting peptidoglycan synthesis
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Bacteria make an altered 30S ribosomes that does not bind to the drug.
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Bacteria make a form of 50S ribosome that does not binds to the drug.
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Bacteria make an altered polymerase that does not binds to the drug.
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Binds to the RNA polymerase; inhibiting initiation of RNA synthesis
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Bind to 50S ribosome subunit, inhibiting formation of peptide bonds
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tumors where some cells may develop resistance to the drugs used in
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Drug inactivation or modification: e.g., enzymatic deactivation of
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Binds to DNA topoisomerase, an enzyme essential for DNA synthesis
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Bacteria make an altered enzyme that does not binds to the drug.
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or condition. The term is used in the context of resistance that
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in some penicillin-resistant bacteria through the production of
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World Journal of Gastrointestinal Pharmacology and Therapeutics
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New membrane transport system prevent drug from entering cell.
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Jha, Rajesh; Das, Razib; Oak, Sophia; Mishra, Pravin (2020).
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or cancers have "acquired", that is, resistance has evolved.
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is the reduction in effectiveness of a medication such as an
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Binds to 30S Ribosome subunit, inhibiting protein synthesis
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Binds to 30S Ribosome subunit, inhibiting protein synthesis
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Bind to 50S ribosome subunit, inhibiting protein synthesis
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Bind to 50S ribosome subunit, inhibiting protein synthesis
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10.1603/0022-2585(2008)45[1092:BAMAOD]2.0.CO;2
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Drug, toxin, or chemical resistance is a consequence of
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Beta-lactam antibiotics (penicillin and cephalosporin)
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Beta-lactam antibiotics (penicillin and cephalosporin)
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New membrane transport system pumps drug out of cell.
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BURDEN of Resistance and Disease in European Nations
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Lin, Derek M; Koskella, Britt; Lin, Henry C (2017).
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are posing massive problems for health authorities.
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An illustrative diagram explaining drug resistance.
2150:Battle of the Bugs: Fighting Antibiotic Resistance 1605: 1275: 1273: 982:"Chemo 'Undermines Itself' Through Rogue Response" 230:, mammals, birds, reptiles, fish, and amphibians. 2011:Glew RH, Millering RS, Wennersten C (June 1975). 3002: 2146:- An informative article on multidrug resistance 1822: 1604:Catherine A. Ingraham, John L. Ingraham (2000). 1589:Catherine A. Ingraham, John L. 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A similar asexual method is used by 2195: 2181: 1125:"Mechanisms of drug action and resistance" 905:Jha, Rajesh; Mishra, Pravin (2021-04-19). 504:primary drug treatment with some success. 2796: 2264: 2219: 2095: 2077: 2036: 1987: 1938: 1927:The Journal of Antimicrobial Chemotherapy 1897: 1848: 1799: 1789: 1743: 1686: 1522: 1496: 1218: 1207:Bulletin of the World Health Organization 940: 922: 904: 881: 871: 664: 654: 606:Physical factors affecting microbial life 249:and any cosmetic or health-care product, 177:in 2012 has become a resurgent threat in 1368:"Should antibacterial soap be outlawed?" 1151:International Journal of Pest Management 287:and other penicillin-resistant bacteria. 165:to produce large amounts of the protein 36: 2723: 2431: 1823:Barber M, Waterworth PM (August 1964). 1059: 1040: 14: 3003: 2556: 2486: 1921:Webber MA, Piddock LJ (January 2003). 705: 322:Mechanisms of Acquired Drug Resistance 195:has shown an increasing resistance to 2176: 2017:Antimicrobial Agents and Chemotherapy 1767: 1765: 1763: 1716:Antimicrobial Agents and Chemotherapy 1667:Antimicrobial Agents and Chemotherapy 689:"Antibiotic Resistance and Evolution" 571:(virus that kills bacteria) is used. 2611: 1871: 1865: 1200: 438:Inhibits drug entry or removes drug 2166:: Cancer Drug Resistance Database. 2139:HCMV drug resistance mutations tool 1816: 965:"Tolerance and Resistance to Drugs" 294:-resistant bacteria do not require 24: 2981:Minimum bactericidal concentration 1760: 1244:The Journal of Wildlife Management 611:Small multidrug resistance protein 27:Pathogen resistance to medications 25: 3032: 2116: 1778:Journal of Translational Medicine 1472:"Antibacterial cleaning products" 471: 2971:Minimum inhibitory concentration 2202: 2129:Merck - Tolerance and Resistance 1679:10.1128/AAC.46.11.3381-3385.2002 1515:10.2165/11317030-000000000-00000 1497:Li XZ, Nikaido H (August 2009). 1091:Current Opinion in Biotechnology 788:10.1016/B978-008045382-8.00161-1 483:required to achieve a function. 185:, and drug-resistant strains of 2911:WHO list of essential medicines 2404:Non-specific effect of vaccines 2053: 2004: 1955: 1914: 1703: 1654: 1582: 1539: 1464: 1421: 1378: 1360: 1338: 1313: 1295: 1235: 1194: 1169: 1135: 1117: 1082: 1053: 1034: 975: 2966:Antimicrobial pharmacodynamics 1000:Journal of Cellular Physiology 969:Merck Manuals Consumer Version 957: 898: 847: 804: 782:. 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Chemotherapy causes 111:Pseudomonas aeruginosa 42: 2941:Antibiotic resistance 2733:Clinical pharmacology 2252:Physiological agonist 2212:Ligand (biochemistry) 586:Fecal bacteriotherapy 581:Antibiotic resistance 509:antibiotic resistance 188:Plasmodium falciparum 95:Staphylococcus aureus 40: 2838:Reverse pharmacology 2748:Pharmacoepidemiology 2589:Biological half-life 2469:Ligand binding assay 2343:Activity at receptor 2237:Irreversible agonist 1728:10.1128/AAC.02096-12 601:Pharmacoepidemiology 596:Multidrug resistance 501:MDR1(p-glycoprotein) 495:In humans, the gene 336:Antimicrobial Agent 2886:Combination therapy 2774:Pharmacoinformatics 2743:Medicinal chemistry 2349:Mechanism of action 2029:10.1128/aac.7.6.828 1890:10.1128/CMR.1.1.109 1063:(20 October 2015). 873:10.3390/ani10101863 709:(16 October 2016). 693:detectingdesign.com 379:Alters drug target 329: 74:multidrug-resistant 3021:Psychopharmacology 2856:Immunopharmacology 2806:Pharmacotoxicology 2707:Psychopharmacology 2499:Intrinsic activity 2399:Pleiotropy (drugs) 2320:Agonist-antagonist 2232:Endogenous agonist 2134:Cosmetics Database 1940:10.1093/jac/dkg050 1285:reptilechannel.com 328: 183:sub-Saharan Africa 43: 2998: 2997: 2994: 2993: 2954: 2953: 2851:Photopharmacology 2846: 2845: 2819: 2818: 2792: 2791: 2756: 2755: 2719: 2718: 2712:Electrophysiology 2702:Neuropharmacology 2657: 2656: 2607: 2606: 2543: 2542: 2530:Therapeutic index 2482: 2481: 2427: 2426: 2376: 2375: 2305: 2304: 2260: 2259: 1356:on 6 August 2011. 1012:10.1002/jcp.26810 832:978-0-309-08854-1 797:978-0-08-045382-8 617:Eleftheria terrae 481:energy metabolism 469: 468: 226:, plants, fungi, 16:(Redirected from 3028: 2956: 2955: 2916: 2915: 2896:Polypharmacology 2821: 2820: 2794: 2793: 2784:Pharmacogenomics 2779:Pharmacogenetics 2758: 2757: 2721: 2720: 2682: 2681: 2609: 2608: 2579:Rate of infusion 2554: 2553: 2549:Pharmacokinetics 2484: 2483: 2429: 2428: 2378: 2377: 2340: 2339: 2335:Pharmacodynamics 2315:Neurotransmitter 2297:Enzyme inhibitor 2262: 2261: 2217: 2216: 2197: 2190: 2183: 2174: 2173: 2110: 2109: 2099: 2081: 2057: 2051: 2050: 2040: 2008: 2002: 2001: 1991: 1974:(13): 1291–302. 1959: 1953: 1952: 1942: 1918: 1912: 1911: 1901: 1869: 1863: 1862: 1852: 1820: 1814: 1813: 1803: 1793: 1769: 1758: 1757: 1747: 1722:(8): 3752–3762. 1707: 1701: 1700: 1690: 1658: 1652: 1651: 1628:Trends Microbiol 1623: 1614: 1613: 1611: 1601: 1595: 1594: 1586: 1580: 1579: 1543: 1537: 1536: 1526: 1509:(12): 1555–623. 1494: 1488: 1487: 1485: 1483: 1468: 1462: 1461: 1425: 1419: 1418: 1382: 1376: 1375: 1364: 1358: 1357: 1352:. 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2928: 2926:Drug tolerance 2922: 2920: 2913: 2908: 2906:Lists of drugs 2903: 2898: 2893: 2888: 2883: 2878: 2876: 2872: 2871: 2869: 2868: 2863: 2858: 2853: 2847: 2844: 2843: 2841: 2840: 2835: 2829: 2827: 2825:Drug discovery 2817: 2816: 2814: 2813: 2808: 2802: 2800: 2790: 2789: 2787: 2786: 2781: 2776: 2770: 2768: 2754: 2753: 2751: 2750: 2745: 2740: 2735: 2729: 2727: 2717: 2716: 2714: 2709: 2704: 2699: 2694: 2692: 2679: 2673: 2672: 2670: 2669: 2667:Bioequivalence 2664: 2658: 2655: 2654: 2652: 2651: 2641: 2636: 2631: 2626: 2615: 2613: 2605: 2604: 2602: 2601: 2596: 2591: 2586: 2581: 2576: 2566: 2560: 2558: 2551: 2545: 2544: 2541: 2540: 2538: 2537: 2532: 2527: 2501: 2496: 2490: 2488: 2480: 2479: 2477: 2476: 2461: 2456: 2451: 2446: 2441: 2435: 2433: 2425: 2424: 2422: 2421: 2411: 2409:Adverse effect 2406: 2401: 2396: 2384: 2382: 2374: 2373: 2371: 2366: 2361: 2356: 2354:Mode of action 2351: 2346: 2344: 2337: 2331: 2330: 2328: 2327: 2322: 2317: 2312: 2306: 2303: 2302: 2300: 2299: 2294: 2289: 2284: 2279: 2274: 2268: 2266: 2258: 2257: 2255: 2254: 2249: 2244: 2239: 2234: 2229: 2223: 2221: 2214: 2208: 2207: 2200: 2199: 2192: 2185: 2177: 2171: 2170: 2161: 2152: 2147: 2141: 2136: 2131: 2126: 2118: 2117:External links 2115: 2112: 2111: 2072:(3): 162–173. 2052: 2003: 1954: 1913: 1864: 1815: 1759: 1702: 1673:(11): 3381–5. 1653: 1615: 1596: 1581: 1538: 1489: 1463: 1420: 1399:10.1086/507964 1377: 1359: 1337: 1312: 1294: 1291:on 2011-01-03. 1269: 1234: 1193: 1168: 1134: 1116: 1081: 1052: 1033: 990: 974: 956: 897: 846: 831: 823:10.17226/10651 803: 796: 770: 743:(2): 333–350. 727: 698: 680: 628: 627: 625: 622: 621: 620: 613: 608: 603: 598: 593: 588: 583: 576: 573: 521:cephalosporins 492: 489: 473: 472:Metabolic cost 470: 467: 466: 457: 448: 439: 435: 434: 416: 398: 380: 376: 375: 366: 357: 348: 344: 343: 340: 337: 334: 323: 320: 319: 318: 307: 288: 277: 258: 255: 129: 126: 86:European Union 56:in treating a 54:antineoplastic 32:Drug tolerance 26: 9: 6: 4: 3: 2: 3033: 3022: 3019: 3017: 3014: 3012: 3009: 3008: 3006: 2987: 2984: 2982: 2979: 2977: 2974: 2972: 2969: 2967: 2964: 2963: 2961: 2957: 2947: 2944: 2942: 2939: 2937: 2934: 2932: 2931:Tachyphylaxis 2929: 2927: 2924: 2923: 2921: 2917: 2912: 2909: 2907: 2904: 2902: 2899: 2897: 2894: 2892: 2889: 2887: 2884: 2882: 2879: 2877: 2873: 2867: 2864: 2862: 2859: 2857: 2854: 2852: 2849: 2848: 2839: 2836: 2834: 2831: 2830: 2828: 2826: 2822: 2812: 2809: 2807: 2804: 2803: 2801: 2799: 2795: 2785: 2782: 2780: 2777: 2775: 2772: 2771: 2769: 2767: 2763: 2759: 2749: 2746: 2744: 2741: 2739: 2736: 2734: 2731: 2730: 2728: 2726: 2722: 2713: 2710: 2708: 2705: 2703: 2700: 2698: 2695: 2693: 2691: 2687: 2683: 2680: 2674: 2668: 2665: 2663: 2660: 2659: 2649: 2645: 2642: 2640: 2637: 2635: 2632: 2630: 2627: 2624: 2620: 2617: 2616: 2614: 2610: 2600: 2597: 2595: 2592: 2590: 2587: 2585: 2582: 2580: 2577: 2574: 2570: 2567: 2565: 2562: 2561: 2559: 2555: 2552: 2550: 2546: 2536: 2533: 2531: 2528: 2525: 2521: 2517: 2513: 2509: 2505: 2502: 2500: 2497: 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387:Erythromycin 385: 381: 378: 377: 374: 371: 367: 365: 362: 358: 356: 353: 349: 347:Destroy drug 346: 345: 341: 338: 335: 332: 331: 326: 316: 312: 308: 305: 304:nucleic acids 301: 297: 293: 289: 286: 282: 278: 275: 271: 269: 264: 263: 262: 254: 252: 248: 244: 240: 236: 231: 229: 225: 221: 217: 216:parasexuality 213: 209: 205: 200: 198: 194: 190: 189: 184: 180: 176: 172: 168: 164: 160: 156: 152: 148: 144: 143:cell-division 139: 135: 125: 121: 119: 118: 113: 112: 107: 106: 105:Streptococcus 101: 97: 96: 89: 87: 82: 77: 75: 71: 67: 63: 59: 55: 51: 50:antimicrobial 47: 39: 33: 19: 2935: 2901:Chemotherapy 2861:Cell biology 2762:Biochemistry 2686:Neuroscience 2634:Distribution 2564:Loading dose 2247:Superagonist 2204:Pharmacology 2069: 2065: 2055: 2020: 2016: 2006: 1971: 1967: 1957: 1930: 1926: 1916: 1881: 1877: 1867: 1832: 1828: 1818: 1781: 1777: 1719: 1715: 1705: 1670: 1666: 1656: 1634:(9): 337–9. 1631: 1627: 1607: 1599: 1590: 1584: 1554:(1): 19–31. 1551: 1547: 1541: 1506: 1502: 1492: 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228:arthropods 2648:Clearance 2644:Excretion 2463:Methods ( 2088:2150-5349 1736:0066-4804 1482:1 October 1186:1 October 1061:Morelle R 933:2049-1891 917:(1): 51. 757:1187-7863 720:1 October 525:nafcillin 515:(such as 491:Treatment 393:Rifampin 247:sunblocks 171:MicroRNAs 151:cancerous 134:evolution 62:pathogens 2766:genetics 2738:Pharmacy 2725:Medicine 2535:Affinity 2494:Efficacy 2432:Analysis 2414:Toxicity 2164:CancerDR 2155:MDRIpred 2106:28828194 1998:21470111 1949:12493781 1859:14160224 1810:30176891 1754:23716056 1697:12384339 1576:13656026 1568:28951954 1533:19678712 1458:27422270 1450:19058634 1415:20734025 1407:17006819 1350:CBC News 1111:12849777 1069:BBC News 1047:BBC News 1028:52092652 1020:30146724 986:BBC News 951:33866972 892:33066185 841:22649806 765:55736918 675:26180516 575:See also 561:bacteria 499:encodes 239:shampoos 2676:Related 2619:(L)ADME 2573:Initial 2557:Metrics 2504:Potency 2487:Metrics 2389:Binding 2359:Binding 2227:Agonist 2097:5547374 2047:1155924 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Index

Resistance to antiviral drugs
Drug tolerance

antimicrobial
antineoplastic
disease
pathogens
Antimicrobial resistance
antineoplastic resistance
multidrug-resistant
European Union
Staphylococcus aureus
enterococci
Streptococcus
Pseudomonas aeruginosa
Acinetobacter baumannii
evolution
fitness
cell-division
horizontal gene transfer
cancerous
chemotherapy
fibroblasts
tumors
WNT16
MicroRNAs
Malaria
South East Asia
sub-Saharan Africa
Plasmodium falciparum

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